Soft tissue surgery in rheumatoid arthritis of the hand.

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Abstract

[Indexed for MEDLINE] 13. Musculoskeletal Care. 2023 Mar;21(1):108-116. doi: 10.1002/msc.1671. Epub 2022 Jul 18. Factors associated with hand bone changes in early rheumatoid arthritis. Valner A(1)(2), Kirsimägi Ü(1), Müller R(1)(2), Kull M(3), Põlluste K(1), Kumm J(1)(2), Lember M(1)(2), Kallikorm R(1)(2). Author information: (1)Institute of Clinical Medicine, University of Tartu, Tartu, Estonia. (2)Internal Medicine Clinic, Tartu University Hospital, Tartu, Estonia. (3)Viljandi County Hospital, Viljandi, Estonia. BACKGROUND: The aim of this research was to assess if hand bone mineral density (HBMD) changes associated with the appearance of erosions in early rheumatoid arthritis (ERA), compared with the population-based control group. Additionally, we tried to identify if there are novel factors that associate with HBMD and erosive changes (EC), and if they are dissimilar. The study was conducted as the data are limited. METHODS: The study group consisted of 83 ERA patients and 321 controls. Dual-Energy X-Ray Absorptiometry (DXA) machine was used to measure HBMD. EC of RA (rheumatoid arthritis) were assessed in X-rays of hands using Sharp scores. Life-style habits, inflammation markers were assessed to evaluate the effects of different factors. RESULTS: The presence of ERA was associated with lower HBMD compared with controls (adjusted for age, gender, height and weight; b -0.01, p = 0.045). 76% (95% CI 65.3-84.6) of ERA patients had EC in hand X-ray. Smoking habits and higher BMI (body mass index) were associated with an increased likelihood of having RA specific EC. In ERA, decreasing of HBMD was associated with the elevation of interleukin-6 (IL-6) and rheumatoid factor (RF) positivity. CONCLUSIONS: In ERA, HBMD changes were not associated with the appearance of erosions. Factors that associate in ERA with HBMD changes and appearance of erosions differ. HBMD assessment together with serum IL-6 level could be useful in everyday clinical practice for better surveillance of ERA patients who do not have EC in hand X-rays. © 2022 John Wiley & Sons Ltd. DOI: 10.1002/msc.1671